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• SAN JOAQUIN COUNTY • <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sieov.orwehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: esignated Operatoy: - Inspection Date: <br /> Facility address: ( r/ ( /� UST# � /�tL, / - / - <br /> 3 S S N 4 uL pr. �J�U� WTD CA 'Product Waa� <br /> Facility Contact: Title: Phone: - - - ' <br /> M 1 ue'L, o rr f erm. M K <br /> onito g Panel: Piping system: Overfill prevention: <br /> ❑Pressurized ❑Suction ravit ❑Mechanical udible/visual <br /> Violations: <br /> inspection type: <br /> Routine )rmonitoring Certification ❑Installation ❑Other: ❑M I-RDeteet ❑M2-RPrev 0 M-3 Both <br /> R <br /> V <br /> # Code Section VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V <br /> V=Violation;RV=R eat Violation <br /> I HSC 25284 Permit too erate <br /> 2 CCR 2637 Seconds containment test erformed <br /> 3 CCR 2711 b)& c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 b Monitorin Pro ram Monitorin &Res onse Plan)is current and aoproved by the local agency. <br /> 6 CCR 2712 i lviuln.rigplanisonsite. M1 <br /> 7 CCR 2712 b Maintenance&monitoring records <br /> 8 CCR 2643 d Dail monitorin of suction i in re-Janus . I, 1984) <br /> 9 HSC 25292.1 UST s stem is o erated to revent unauthorized release (M l) <br /> 10 CCR 2632 c) 2) UST monitorin s--1-;--t MI <br /> I I CCR 2630 d UST s stem monitorin a ui ment is ro erl located to detect a leak (M2 <br /> 12 HSC 25291 b) UST s stem monitorin a ui ment is o erational <br /> 13 CCR 2636 t 1 Continuous monitorin s stem for under ound i in &UDC is resent M 1 <br /> 14 CCR 2631 a Prima containment is product tight <br /> 15 HSC 25291 a 2 Second containment for UST is ti ht <br /> 16 CCR 2636 c l All releases in secondary pipingflow to a collection sum (M 1) <br /> 17 HSC 25291 - Line leak detector(s) are installed (M2) <br /> 18 CCR 2635 b) l S ill container M2 <br /> 19 CCR 2635 b 2 Overfill reventions stem <br /> 20 CCR 2636(a) Conventional suction riving shall have continuous monitorin &2°containment <br /> 21 HSC 25291 (e) Water in 20 containment anal zed& ro erl dis osed of Ml <br /> 22 CCR 2650 Recordin /re orcing of unauthorized releases <br /> 23 CCR 2715 Desi noted O era'--- (a)Statement from USinsT owner; c-e)Monthl ection; t)Employee trainin <br /> 24 CCR 2638 a Annual monitorin certification (MI) <br /> 25 CCR 2638 a) Annual line leak detector test <br /> 26 HSC 25284.2 Annuals ill containment testin Ml) <br /> 27 CCR 2636 4 Annual line tightness test (M2) <br /> 28 CCR 2661 t Re air for tank/piping has had tightness test <br /> 29 CCR 2643 e) Biennial tightness test of gravity pipingre-Janus I, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction pipina(pre-Jan ary I, 1984) MI) <br /> 31 HSC 25292.5 Double walls stem located within 1000' of ublic well-ELD <br /> 32 CCR 2661 Permit to re air UST s stem <br /> 33 HSC 25286 a Permit to alter monitoring s stem <br /> 34 HSC 25298 b) Permit to tem oraril close UST system <br /> 35 HSC 25298 c) Permit to close UST system <br /> 36 HSC 25299('10) Disabling leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST s stem <br /> -38—J Other: <br /> E�t�J/INNSPECTOR�:rJ� /1 PHONE: UIC <br /> V V`1 V U•_ �j�, <br /> Sery0 people/day <br /> RECEIVE Y: TITLE: Receives than sanitary waste <br /> O� Other disocsal me[ho <br /> wells/French O <br /> H <br /> EHD 23-02-002 REV 05/07 <br />